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Farooq M, Scalia G, Umana GE, Parekh UA, Naeem F, Abid SF, Khan MH, Zahra SG, Sarkar HP, Chaurasia B. A Systematic Review of Nanomedicine in Glioblastoma Treatment: Clinical Efficacy, Safety, and Future Directions. Brain Sci 2023; 13:1727. [PMID: 38137175 PMCID: PMC10742051 DOI: 10.3390/brainsci13121727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/13/2023] [Accepted: 12/17/2023] [Indexed: 12/24/2023] Open
Abstract
(1) Background: Glioblastoma (GBM) is categorized as a grade IV astrocytoma by the World Health Organization (WHO), representing the most aggressive and prevalent form of glioma. It presents a significant clinical challenge, with limited treatment options and poor prognosis. This systematic review evaluates the efficacy and safety of various nanotherapy approaches for GBM and explores future directions in tumor management. Nanomedicine, which involves nanoparticles in the 1-100 nm range, shows promise in improving drug delivery and targeting tumor cells. (2) Methods: Following PRISMA guidelines, a systematic search of databases including Google Scholar, NCBI PubMed, Cochrane Library, and ClinicalTrials.gov was conducted to identify clinical trials on GBM and nanomedicine. The primary outcome measures were median overall survival, progression-free survival, and quality of life assessed through Karnofsky performance scores. The safety profile was assessed by adverse events. (3) Results: The analysis included 225 GBM patients, divided into primary and recurrent sub-populations. Primary GBM patients had a median overall survival of 6.75 months, while recurrent GBM patients had a median overall survival of 9.7 months. The mean PFS period was 2.3 months and 3.92 months in primary GBM and recurrent GBM patients, respectively. Nanotherapy showed an improvement in quality of life, with KPS scores increasing after treatment in recurrent GBM patients. Adverse events were observed in 14.2% of patients. Notably, Bevacizumab therapy exhibited better survival outcomes but with a higher incidence of adverse events. (4) Conclusions: Nanotherapy offers a modest increase in survival with fewer severe side effects. It shows promise in improving the quality of life, especially in recurrent GBM patients. However, it falls short in terms of overall survival compared to Bevacizumab. The heterogeneous nature of treatment protocols and reporting methods highlights the need for standardized multicenter trials to further evaluate the potential of nanomedicine in GBM management.
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Affiliation(s)
- Minaam Farooq
- Department of Neurological Surgery, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY 10021, USA;
| | - Gianluca Scalia
- Neurosurgery Unit, Department of Head and Neck Surgery, Garibaldi Hospital, 95123 Catania, Italy
| | - Giuseppe E. Umana
- Department of Neurosurgery, Gamma Knife and Trauma Center, Cannizzaro Hospital, 95126 Catania, Italy;
| | - Urja A. Parekh
- German Cancer Research Center, 69120 Heidelberg, Germany;
| | - Faiza Naeem
- Department of Neurosurgery, King Edward Medical University, Lahore 54000, Pakistan; (F.N.); (S.F.A.); (M.H.K.); (S.G.Z.)
| | - Sayeda Fatima Abid
- Department of Neurosurgery, King Edward Medical University, Lahore 54000, Pakistan; (F.N.); (S.F.A.); (M.H.K.); (S.G.Z.)
| | - Muhammad Hammad Khan
- Department of Neurosurgery, King Edward Medical University, Lahore 54000, Pakistan; (F.N.); (S.F.A.); (M.H.K.); (S.G.Z.)
| | - Shah Gul Zahra
- Department of Neurosurgery, King Edward Medical University, Lahore 54000, Pakistan; (F.N.); (S.F.A.); (M.H.K.); (S.G.Z.)
| | - Hrishikesh P. Sarkar
- Department of Neurological Sciences, Kokilaben Dhirubhai Ambani Hospital, Mumbai 400053, India;
| | - Bipin Chaurasia
- Department of Neurosurgery, Neurosurgery Clinic, Birgunj 44300, Nepal;
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